Avcu Serhat, Akdeniz Hüseyin, Arslan Harun, Toprak Nurşen, Unal Ozkan
Department of Radiology, Yüzüncü Yil University School of Medicine, Van, Turkey.
JOP. 2009 Jul 6;10(4):438-40.
Osteosarcoma is the most common malignant bone tumor in children and adolescents and possesses a high potential for metastasis. The most common sites of osteosarcomatous metastases are the lungs, pleurae, and bone; the pancreas being extremely rare.
We report the computed tomography findings of a rare case of pancreatic metastasis in a 14-year-old boy with primary vertebral osteosarcoma being followed-up for 6 years. On abdominal CT, a huge mass containing necrotic and calcified areas and causing bone destruction was seen between thoracic vertebra 7 and sacral vertebra 1 involving both the vertebrae and paravertebral soft-tissue. A large metastatic mass with an irregular contour was also visualized in the pancreatic head and peripancreatic region having tomographic findings similar to the vertebral mass. Tru-cut biopsy of the pancreatic mass confirmed the diagnosis of osteosarcoma metastasis.
Although extremely rare, osteosarcoma metastasis should be included in the differential diagnosis of pancreatic mass lesions, particularly in patients with a primary tumor.
骨肉瘤是儿童和青少年中最常见的恶性骨肿瘤,具有很高的转移潜能。骨肉瘤转移最常见的部位是肺、胸膜和骨;转移至胰腺极为罕见。
我们报告了一名14岁男孩罕见的胰腺转移病例的计算机断层扫描结果,该男孩患有原发性椎体骨肉瘤,已随访6年。腹部CT显示,在第7胸椎和第1骶椎之间可见一个巨大肿块,包含坏死和钙化区域,并导致骨质破坏,累及椎体和椎旁软组织。胰头和胰周区域也可见一个轮廓不规则的大转移肿块,其断层扫描表现与椎体肿块相似。胰腺肿块的粗针穿刺活检证实为骨肉瘤转移。
尽管骨肉瘤转移极为罕见,但在胰腺肿块病变的鉴别诊断中应考虑到,尤其是对于患有原发性肿瘤的患者。